| Village Creek Counseling, Pllc | |
|
3597 E Monarch Sky Ln # F240 Meridian ID 83646-1053 | |
| (208) 522-7512 | |
| (208) 401-3701 |
| Full Name | Village Creek Counseling, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3597 E Monarch Sky Ln # F240, Meridian, Idaho |
| Authorized Official Name and Position | Melissa Leigh Marquez (SOLE PROPRIETOR) |
| Authorized Official Contact | 2085227512 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Village Creek Counseling, Pllc 3597 E Monarch Sky Ln # F240 Meridian ID 83646-1053 Ph: (208) 522-7512 | Village Creek Counseling, Pllc 3597 E Monarch Sky Ln # F240 Meridian ID 83646-1053 Ph: (208) 522-7512 |
| NPI Number | 1083329585 |
|---|---|
| Provider Enumeration Date | 01/18/2023 |
| Last Update Date | 01/18/2023 |
| Certification Date | 01/18/2023 |
| Medicare PECOS PAC ID | 4688039860 |
|---|---|
| Medicare Enrollment ID | O20230421000864 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083329585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Melissa L Marquez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083853477 PECOS PAC ID: 4789011891 Enrollment ID: I20200303000578 |
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